患有先天性隔膜的婴儿口服营养延迟的风险因素和发育关系
Taku Yamamichi1, Yousuke Imanishi2, Takaaki Sakai3
1Department of Pediatric Surgery, Osaka Women's and Children's Hospital, 840 Murodo, Izumi, Osaka, 594-1101, Japan. yamamichi@pedsurg.med.osaka-u.ac.jp.
Pediatric surgery international
|November 22, 2023
概括
大型先天性隔膜 (CDH) 缺陷和长时间的通风是延迟口腔营养的关键风险因素. 这种延迟显著增加了CDH婴儿发育延迟的风险.
科学领域:
- 儿科手术 儿科手术
- 新生儿科学 新生儿科学
- 发育儿科 发育儿科
背景情况:
- 先天性隔膜 (CDH) 是一种复杂的出生缺陷,需要密集的新生儿护理.
- 营养支持和食进展是CDH管理的关键方面.
- 在CDH幸存者的发育结果是一个重大问题.
研究的目的:
- 确定与先天性隔膜 (CDH) 诊断的婴儿延迟口服营养相关的风险因素.
- 确定延迟口服营养对18个月龄的CDH患者发育延迟的影响.
主要方法:
- 在2006年至2020年期间对80名患有孤立CDH的婴儿进行了回顾性单中心队列研究.
- 评估临床参数以确定延迟口服营养的风险因素,定义为从机械通风断到输管养断的时间≥30天.
- 多变量分析以确定口腔营养延迟的独立风险因素及其与发育延迟的关联.
主要成果:
- 在80名婴儿中,有26名婴儿 (32.5%) 经历了口服营养延迟.
- 延迟口腔营养的独立风险因素包括缺陷大小 (>50%到几乎全部缺陷) 和通风时间≥9天 (调整后的OR分别为4.65和6.02).
- 延迟口服营养与18个月后发育延迟的可能性更高显著相关 (原始OR 4.16).
结论:
- 大缺陷尺寸和长时间的机械通风 (≥9天) 是CDH婴儿口服营养延迟的重要独立风险因素.
- 延迟口服营养是先天性腹膜的婴儿发育延迟的有力预测因素.
- 积极的发育护理对于经历延迟口服营养的CDH患者至关重要.
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